The ultimate goal of this Mentored Research Scientist Development Award (K01) is to provide the applicant with the skills to establish an independent program of research in the sociology of health and aging as applied to the needs and concerns of minority populations. The immediate goal is, for the first time, to use an objective instrument to investigate patterns of communication characterizing interactions between American Indian elder patients and their health care providers. Consistent with recent models for medical communication, the project will investigate whether providers display bias by varying their communicative behavior according to their American Indian patients' cultural characteristics, and if American Indian patients (or patient subgroups) use distinctive communication norms. The project will then seek to relate observed patterns in patient and provider communication to patients' satisfaction and providers' "clinical uncertainty." Finally, the project will use the resulting information to design and target a health intervention aimed at improving medical communication with American Indian elder patients, with special attention to patient subgroups who may have special needs. The applicant is an American Indian with graduate training in sociology, a background of research and publication related to the study of communication and Native American issues, and a current affiliation with a nationally known research center dedicated to the study of American Indian health. She will be assisted in her project by intensive mentoring and consultation from an established group of researchers with expertise in the study of aging, ethnicity, and health; medical communication and its assessment; intervention research, Indian health policy, and quantitative research methodologies. The research plan for this award involves extending a pilot study that collected data from both health care providers and patients at one Cherokee Nation tribal health clinic in the summer of 2001. Proposed data collection will occur at two additional tribal clinics. New data is to be combined with pilot data, thus yielding a larger and more diverse sample of elders (n = 300), and allowing new questions regarding doctor-patient communication among American Indians to be addressed. Additionally, the research plan will allow the researcher to pursue the following specific goals: (1) receive mentorship in the social scientific study of health and aging, (2) develop particular expertise in the area of health and aging in minority populations, (3) receive training in quantitative methodologies, (4) develop knowledge of the theory, practice, and assessment of medical communication, and the ability to translate findings into efficacious interventions, and (5) achieve greater understanding of the federal and tribal policies that affect Indian health care, and of the individual clinical settings in which health communication occurs.